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Mechanisms of Failure and Outcome of Secondary Surgical Interventions After Thoracic Endovascular Aortic Repair (TEVAR)  Julia Dumfarth, MD, Marc Michel,

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Presentation on theme: "Mechanisms of Failure and Outcome of Secondary Surgical Interventions After Thoracic Endovascular Aortic Repair (TEVAR)  Julia Dumfarth, MD, Marc Michel,"— Presentation transcript:

1 Mechanisms of Failure and Outcome of Secondary Surgical Interventions After Thoracic Endovascular Aortic Repair (TEVAR)  Julia Dumfarth, MD, Marc Michel, MD, Jürg Schmidli, MD, Gottfried Sodeck, MD, Marek Ehrlich, MD, Michael Grimm, MD, Thierry Carrel, MD, Martin Czerny, MD  The Annals of Thoracic Surgery  Volume 91, Issue 4, Pages (April 2011) DOI: /j.athoracsur Copyright © 2011 The Society of Thoracic Surgeons Terms and Conditions

2 Fig 1 Freedom from secondary open surgical conversion after thoracic endovascular aortic repair. (IQR = interquartile range; Pts = patients.) The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2011 The Society of Thoracic Surgeons Terms and Conditions

3 Fig 2 Axial computed tomographic scan of a patient with a newly developed type Ia endoleak in the distal aortic arch due to a short landing zone showing antegrade reperfusion of the aneurysmal sac. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2011 The Society of Thoracic Surgeons Terms and Conditions

4 Fig 3 Sagittal computed tomographic scan of a patient after thoracic endovascular aortic repair for a traumatic aortic lesion with classical infolding, as well as a bird's beak formation of the proximal prosthesis due to low radial force and a steep angulated aortic arch. Both factors led to proximal reperfusion of the aortic lesion. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2011 The Society of Thoracic Surgeons Terms and Conditions

5 Fig 4 Sagittal computed tomographic scan of a patient after thoracic endovascular aortic repair for aneurysmal formation on the basis of a chronic type B dissection with rupture of the dissecting membrane at the distal end of the stent-graft leading to reperfusion of the false lumen and consecutively rapid expansion of the aneurysmal sac. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2011 The Society of Thoracic Surgeons Terms and Conditions

6 Fig 5 Sagittal computed tomographic scan of the patient after thoracic endovascular aortic repair for acute complicated type B dissection revealing an asymptomatic retrograde type A aortic dissection 6 months after initial treatment. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2011 The Society of Thoracic Surgeons Terms and Conditions

7 Fig 6 (A) Sagittal computed tomographic scan of a patient with multi-segmental thoracic aortic disease showing a steep angulation at the thoraco-abdominal transition. (B) The same patient after a twofold frustraneous attempt of distal extension with no effect due to persisting reperfusion of the aneurysmal sac due to the angulated anatomy. (C) The same patient after thoraco-abdominal replacement with incorporation of the proximal parts of the stent-graft into the anastomosis. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2011 The Society of Thoracic Surgeons Terms and Conditions

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